20/20 Visioning

Without a goal and a direction, progress is unlikely—or at least unrecognizable. Decisions about direction, strategy, recruitment, alignment, and even day-to-day activities lack a compass and yardstick to prompt and guide action. When hospitals, health systems, and academic medical centers launch initiatives, it’s often in response to external pressures from payers, patients, and the community, or from internal constituencies such as departments, physician groups, or even a single powerful leader. Without reference to a long-term goal or strategy, these initiatives usually fail. The resulting disappointment and cynicism can make it harder for an organization to make changes the next time.

For a program to provide real improvement, it needs to be guided by a coordinated, widely-shared picture of the organization’s future. Most visions represent aspirations: Pictures of the future represent descriptions of how things will look and operate when we’ve achieved our intentions. Linked to a timeline and strategy, a picture of the future becomes a powerful tool for improving outcomes, safety, quality, and business performance, as well as staff morale and satisfaction. People respond cynically to isolated policies and programs that are not tethered to well-defined intended results: There is no context, so those in the system create their own understanding based on the isolated fragments of activity that they see. To provide the motivating energy for sustained change, organizations need the clarifying simplicity of a concrete goal: Think of the energy mobilized by John F. Kennedy’s declaration on September 12, 1962 of the United States’ intention to place a man on the moon.

In the typical healthcare organization, key leaders, such as the Board, executive management, and physician leaders may have a sense of where the organization could be in five years, but it is not usually front-and-center in discussions about improving specific areas, and it may never have been shared or made explicit. For the middle managers who must carry out policy, the lack of clarity about “where the organization is going” makes it much more difficult to justify everyday decisions and actions. But linking a decision or action to the intended picture of the future provides the reason and context.

The Bard Group’s 20/20 Visioning process helps an organization’s leaders clarify that picture by bringing it to the surface, articulating it, refining it, and agreeing upon it. Borrowing from a concept in Jim Collins’ book Good to Great, we interview selected leaders—typically 20 to 40—individually or in a group retreat setting, on three key points:

• Passion: What ignites the passion of your constituents: physicians, administrators, employees? What do they care deeply about?
• Market leadership: What can your hospital or health system do better than any competitor in its market? This need not be an area where you are currently engaged, but you do need to zero in on what is realistic for you. Equally important, where do you know you cannot be the best?
• Economic driver: What activities will generate financial stability and increase your economic viability?

Using the information from these discussions and our expert knowledge of what is working effectively in healthcare organizations across the country, we help develop a both a picture of the future and the strategy roadmap for how best to achieve it.

To learn more about 20/20 Visioning, or any of The Bard Group’s capabilities, contact us.